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Glasgow University Library 



ALL ITEMS ARE ISSUED SUBJECT TO RECALL 

GUL 96.18 



THE ANNUAL ADDRESS 

DELIVERED TO THE 

3YAL COLLEGE OF PHYSICIANS 



On April 6, 1914 



BY 

THE PRESIDENT 

Sir THOMAS BARLOW, Bt., K.C.V.O., M.D., F.R.S. 



UonDon 

JOHN BALE, SONS & DANIELSSON, Ltd. 

OXFORD HOUSE 

83-91, GREAT TITCHFIELD STREET, OXFORD STREET. W. 



UN ". ■ 
LIBRA 



PRESIDENTIAL ADDRESS. 



In the List for 1914, there appear 345 fellows as 
compared with 334 in 1913, 505 members as compared 
with 506 in 1913, 12,472 licentiates as compared with 
12,220 in 1913. 

During the year 1913 there died six fellows, ten 
members, one hundred and twenty licentiates. Seventeen 
new fellows were elected, of whom sixteen were members 
and one was not a member ; fourteen licentiates were 
admitted to the membership ; one member resigned, and 
one diploma of membership which had been relinquished 
was restored by sanction of the College on the desire of 
the member to resume his membership ; two licentiates 
were removed from the College List. 

Birthday Honours, 1913 :— Oliver, Charles Pye, M.D., 
L.R.C.P. (Hon. Physician to the King); Jones, John 
Arnallt, M.D., L.R.C.P. (Hon. Surgeon to the King) ; 
Worthington, Edward Scott, M.D., L.R.C.P. (a knight- 
hood); Spurrier, Alfred Henry, L.R.C.P. (C.M.G.); 
Giffurd, Gerald Godfrey, Lieutenant-Colonel LM S 
M.R.C.P. (C.S.L). 

New Year Honours, 1914 :— May, Arthur William, 
C.B., L.R.C.P., Director-General R. Nav. Med. Service 
(Hon, Physician to the King). 

The Harveian oration was delivered on St. Luke's Day 
by Dr. Mitchell Bruce, the subject being "The Influence 
of Harvey's work in the Development of the Doctrine of 
Infection and Immunity." 

Lectures (in chronological order) : The Oliver Sharpey 
lectures for 19 13 were delivered by Professor A. D. 



4 



Waller, on "The Electrical Action of the Human Heart" ; 
the Croonian lectures by Professor Sherrington, on " In- 
hibition as an Element in Co-ordination " ; the Bradshaw 
lecture, by Dr. T. K. Glynn, on " Hysteria in some of its 
Aspects " ; the Fitzpatrick lectures for 1913, by Dr. C. A. 
Mercier, on " Astrology in Medicine" ; the Milroy lectures, 
1914, by Dr. F. Shufflebotham, on "The Hygienic Aspect 
of the Coal-mining Industry in the United Kingdom"; 
the Goulstonian lectures by Dr. M. A. Cassidy, " Rheu- 
matoid Arthritis " ; the Lumleian lectures, by Dr. J. A. 
Ormerod, on "Some Modern Theories concerning 
Hysteria " ; the Oliver Sharpey lectures for 1914, by Dr. 
F. Gowland Hopkins, on " Some Effects which follow 
upon Disturbances in the Chemical Reaction of the 
Blood." 

The College is grateful to the Harveian orator for his 
discourse, which was full of philosophical reflections on 
the evolution of doctrine and practice as regards infec- 
tious diseases since Harvey's time, and is also grateful to 
its lecturers who have given admirable reviews of the 
most recent additions to our medical knowledge. 

With the consent of Dr. George Oliver certain altera- 
tions have been made in the regulations concerning the 
Oliver Sharpey lectures, the principal of which is that it 
is now no longer required that they should be delivered 
in this College in the month of April, a time which owing 
to press of other College business has sometimes proved 
inconvenient. 

CONGRESSES. 

The International Congress of Medicine was held in 
London in August, 191 3. The President of this College 
was the President of the Congress, and one of the most 
successful sections, viz., that of the history of medicine, 
was held in our large library under the chairmanship of 
Dr. Norman Moore. Prior to the assembling of the 
Congress the meetings of the officers and of the Executive 
and Reception Committees were all held beneath our 



5 



roof, and the College gave ,^50 towards the expenses of 
the Congress, 

The fourth International Congress on Physio-Thera- 
peutics was held in Berlin. Dr. Garrod attended as 
delegate of the College and of H.M. Government, and 
presented a report to the College on April 12. 

The third International Congress on Neurology and 
Psychiatry was held in Ghent. Dr. Aldren Turner 
attended in similar capacities, and presented a report to 
the College on October 30. 

SCHOLARSHIPS AND MEDALS. 

The Baly medal for distinction in physiology was 
awarded to Dr. John Scott Haldane, F.R.S. ; the Swiney 
prize was awarded by this College in conjunction with 
the Society of Arts (on this occasion for a w^ork on 
general jurisprudence) to Mr. J. W. Salmond ; the 
Murchison Memorial Scholarship was awarded (on this 
occasion by the University of Edinburgh) to Alan W. 
Sichel, B.A., M.B. The Jenks scholarship was awarded 
by the president and censors to Mr. Frank Caldecott. 

CENSORS" BOARD. 

The Board have recommended certain minor altera- 
tions in relation to the membership examination, which 
have been accepted by the College. These are : — 

(r) That when a candidate has been referred, he may 
present himself again for examination after an interval of 
six months, instead of twelve months, as formerly was 
the case. 

(2) That the duration of the two wa-itten examinations 
be reduced from four hours to three. 

A member (Dr. William Rees Thomas) having presented 
himself for examination in psychological medicine. Dr. 
Percy Smith and Dr. Craig were asked by the Board to 
undertake the examination. The candidate passed to 
their satisfaction, and was granted the certificate. 



6 



A letter was read to the College on March 17, 19 13, 
asking whether in the opinion of the College, membership 
of a (medical) trades union would, ipso facto, be con- 
sidered derogatory to the dignity of the profession. 

This was referred to the Censors' Board, who after 
obtaining the opinion of the College solicitors upon the 
legal position of trades unions and upon other points 
connected therewith, interviewed two gentlemen specially 
connected with the newly founded National Medical 
Guild. The Censors' Board, after full consideration, re- 
ported to the College, that in their opinion, ''there is 
much both in the constitution and in the methods of 
trades unions, which as applied to medicine could not 
fail to be derogatory to the medical profession." 

This opinion was endorsed by the College, July 3, 

1913- 

A question was brought before the Board concerning 
the position of infirmary medical officers in relation to 
the notification of abortion. Sir Arthur Downes and 
Mr. Lithiby, of the Local Government Board (to which 
a Board of Guardians had applied for assistance and 
information), appeared before the President and Censors. 
The Local Government Board desired to know in detail 
the legal opinion given to the College in relation to the 
case of Kitson versus Playfair, but were unable to obtain 
this opinion since it was declared at the time to be 
" Sccreta Collegii." The Board advised the College to 
communicate to the Local Government Board this 
opinion, which was embodied in the report of a Com- 
mittee presented to the College on April 30, 1896. The 
College did so. No further communication has yet been 
received from the Local Government Board as to their 
views of the duty of notifying abortions in infirmary 
practice. 

Sundry other matters which have occupied the attention 
of the Board will be found under other headings {I'ide 
infra). 

On the advice of the Committee of Management the 



examination for the diploma in diseases and hygiene of 
the Tropics has been divided into two parts. The first 
part is concerned with laboratory work and the second 
with clinical subjects. The candidate must now satisfy 
the examiners in the first part before being allowed to 
take the second part. The examinations will henceforth 
be held in the months of April and July, instead of April 
and October. The abbreviated title for the diploma is 
now D.T.M. and H. England, instead of D.T.M. 

The examinations of the Egyptian School of Medicine 
at Cairo, held during the winter 1912-13, were visited by 
Sir H. Morris on behalf of the two Colleges, and the 
thanks of the College were given to him for his valuable 
report. Sir Watson Cheyne was the visitor last winter. 

GENERAL MEDICAL COUNCIL. 

In the relations of the College and the General Medical 
Council, there has been nothing of importance to note. 

GOVERNMENT DEPARTMENTS. 

The Home Office has on several occasions asked the 
opinion of the College on the status of certain hospitals, 
with reference to a request from their respective govern- 
ing bodies for permission to use the title "Royal." 
The College has given its advice, either for or against, 
in most instances; but the last two letters have been 
referred to the Censors' Board for further consideration. 

The Privy Council forwarded to the College a long 
letter from Dr. E. W. G. Masterman concerning the 
International Health Bureau at Jerusalem. Dr. Master- 
man urged that Great Britain should send out a biologist 
or protozoologist to take charge of a department in this 
Bureau. The letter, after being read to the College, was 
printed and circulated with an invitation to fellows to 
write their opinion to the Censors' Board. The Censors' 
Board, after considering these opinions, drew up an answer 



8 



(which was adopted by the College), approving in general 
terms of the project, but pointing out that an adequate 
stipend should be provided for any such scientific 
director. 

The Royal Commission on Venereal Diseases asked 
from the College suggestions as to suitable witnesses to be 
called before them, especially on the indirect effects of 
syphilis in producing organic disease, and on the subject 
of remedial measures. 

Dr. Mott was chosen as a representative of the College, 
and it was left to the President to appoint other repre- 
sentatives if desirable. 

Those who eventually gave evidence on behalf of the 
College were the President, Dr. Risien Russell, Dr. 
Amand Routh, and Sir Clifford Allbutt. 

NATIONAL HEALTH INSURANCE. 

The Commissioners asked (October, 1914) whether the 
College would desire to give evidence before a Depart- 
mental Committee appointed to report upon alleged 
excessive claims in respect of sickness. The committee 
appointed under the title of the Sickness Benefit Claims 
Committee, in repeating this invitation, sent a sketch of the 
headings into which such evidence would properly fall 
(December 22). This w^as circulated to the fellows and 
considered (June 29, 1914). It appeared that most of the 
information was such as could only be given first hand 
by those working under the Act, but that on one or two 
points the evidence of fellows might be useful ; it was, 
therefore, decided that the College could not in its cor- 
porate capacity give evidence, but that the President be 
authorized to ask certain fellows to give their individual 
opinion and experience on some of the points raised. 

The fellows thus nominated by the President were 
Dr. F. J. Smith, Dr. Michell Clarke and Dr. Amand 
Routh. 

A correspondence took place in April and May last 



9 



year between the Censors' Board and the Commissioners 
as to how far unqiiahfied practitioners could be employed 
under the Act. It was made perfectly clear that such 
persons could not in any case be placed upon the panel^ 
but that when an insured person made his own arrange- 
ments he could with certain restrictions employ un- 
qualified practitioners. How far these unqualified per- 
sons were to be recognized under the Act, e.g., in the 
way of certificates signed by them and in the payment of 
their bills, could not be ascertained from the Commis- 
sioners' replies. 

The correspondence was renewed in February, 1914, 
and the Board having ascertained that in the newly 
issued regulations such unqualified persons are recog- 
nized will submit their report thereon to the present 
Comitia.^ 

SPECIAL COMMITTEES. 

The CoiMMiTTEE FOR Revising the " NomexN'clature 

OF Diseases." 

The work is in progress, and the Sub-committee of 
Classification has held regular meetings at the College. 

C-.)MMITTEE UPON INFECTIVITV OF TUBERCULOSIS. 

This committee, appointed July 3, 19 13, in view of the 
exaggerated fears entertained by the public of infection 
by tuberculosis has held several meetings, and will to-day 
present a report to the College.^ 

FINANCE. 

A report from the Building Committee (December 3, 
1913) stated that the accounts for the new Examination 
Hall were finally settled. The site, building, and exira 



' VtWe Appendix I. 
- I^ide Appendix II. 



10 



expenses had cost the Colleges ;^54,405 19s. 2d. (after 
deducting the amount, viz., £sfi22 6s. 2d., paid by the 
Imperial Cancer Research Fund). The amount received 
for sale of tlie old Examination Hall (less commission 
and expenses) was ^^49,024 4s. lod. The cost to the 
Colleges has therefore been, roughly, ;^5,4oo. 

Turning to the report of the Conjoint Finance Com- 
mittee, December 18, 191 3, it will be seen that the amount 
paid over in 191 3 to the two Colleges exceeds that paid 
over in the last year of occupation of the old hall by 
more than ^3,000 ; it appears therefore that the new hall 
is more than paying for itself. 

In the reports of the College Finance Committee, the 
principal item of interest is the recommendation (Decem- 
ber 3, 1913) adopted by the College, that a claim should 
be submitted to the Corporation of the City of London 
for ;^9,820 in view of the compulsory sale of the College 
property, No. 48, Knighlrider Street, which it appears 
will be bought by the Corporation to make the approaches 
towards the new bridge which is contemplated. 

On the recommendation of the Finance Committee 
(March 17, 1913) carpets have been laid down (for the 
first time !) in the large library, at a cost of ;^8o ; it has 
also been resolved to renovate the lecture theatre, and to 
procure a lecture lantern and an epidiascope. 

GIFTS. 

Mrs. Theodore Williams presented to the College a 
collection of early forms of stethoscope, including one 
made and used by Laennec. The collection had been 
the property of the late Dr. Theodore Williams. 

Dr. W. H. Dickinson left to the College a gold snuff- 
box which had been in the possession of Dr. Richard 
Warren, Dr. Pelham Warren, Dr. James Arthur Wilson, 
and Dr. W. H. Dickinson. 

Dr. W. S. Greenfield presented to the College an auto- 
graph letter from Cullen to William Hunter ; and Mrs. 



1 1 



F. T. Bond presented an autograph letter from Jenner 
to Dr. Baron (his biographer). 

The reversion of a portrait of Dr. James Hope has been 
promised to the College by his son, Sir Theodore Hope. 

To the Library, Lady Allchin presented a selection of 
books from the library of the late Sir William Allchin. 

Finally I have the pleasure to announce that a lady, 
who for the present desires that her name should not be 
mentioned, has made provision in her will that the bulk 
of her fortune shall ultimately come into the possession 
of this College. The terms of the will, which I have seen, 
are that the money is "to be used by the College for 
scientific purposes, simply and solely with a view to the 
discovery of means conducing to the alleviation of 
human suffering and to the prevention and cure of 
disease .... whether such use shall take the form 
of studentships, scholarships, grants in aid of special 
research or otherwise as shall be determined by the 
said College." 

In an interview with this lady I have ascertained that, 
should the College so determine, the establishment and 
endowment of a laboratory for research would meet 
with her entire approval. 

It is proper that I should state that we in this College 
are indebted to Dr. T. B. Scott, of Bournemouth, for 
the enlightened direction given to our benefactress's 
generosity by his friendly and public-spirited advice. 



OBITUARIES. 
PHILIP FRANK. 

Philip Frank died March 17, 1913, at Elvaston 
Place, Kensington, in his 83rd year. He was born in 
1830, the son of a Manchester merchant who migrated 
from Hanover to England in his nineteenth year, was 
naturalized and became a member of the German com- 
munity that did so much for the general culture and civic 



12 



advancement of their adopted city. His mother was a 
Lancashire lady whose maiden name was Miss Maria 
Jackson. 

Frank began his education at a school of much repute 
kept by a Mr. Merz. He spent one year in Hamburg 
and then returned to his Manchester school till he was 
13, and subsequently became a pupil at the Gymnasium 
at Salzwedel in the Altmark, whence, after passing his 
school leaving examination, he entered at the University 
of Berlin, and graduated as M.D, in 1853. 

During the last fourteen months of his University 
curriculum he enjoyed the privilege of acting as 
amanuensis to Professor von Langenbeck. This carried 
with it a post in the operating theatre, and during the 
same period he served as clinical clerk and dresser to 
A. Wagner in one of the divisions of Langenbeck's 
hospital and polyclinic. He likewise served under Gurlt, 
who was subsequently professor of surgery in Berlin, 
and under Busch who was subsequently professor of 
surgery in Bonn ; and his intimate relationships with 
these distinguished men continued throughout their 
life-time. 

After he had taken his M.D. he went as a post-graduate 
to the general hospital of Vienna and studied under 
Rokitansky, Hebra, Oppolzer and others ; thence, at the 
request of his friend and former chief, Wagner, who had 
been placed at the head of the hospital at Danzig, Frank 
went to take charge of the cholera wards there. After 
the subsidence of the epidemic he remained for a time 
as one of the four resident officers of the hospital. 
Then he returned to England, passed the examination of 
the Army Medical Board and was sent to the general 
hospital at Fort Pitt, whence he was ordered to Malta ; 
there he had much hard work attending the wounded 
soldiers who had been drafted over from the Crimean 
field hospitals. 

He then served in succession at the Piraeus, 
Aldershot, Berwick-on-Tweed, Cape Town, Natal, 



13 



Cawnpore and Lucknow. In December, 1859, he was 
invalided on account of dysentery, but it is characteristic 
of him that during five months of his leave he obtained 
permission to study at BerHn, and in July, i860, he began 
two of the most fruitful years of his life, during which he 
was attached to the hospital at Fort Pitt, Chatiiam, This 
was at that time the head-quarters of the Army Medical 
School, and Frank was appointed assistant to Sir Thomas 
Longmore, the professor of surgery. Besides his ward 
duties he took part in pathological work under Aitken 
and in the operation courses of Longmore, and was 
appointed instructor in eye diseases and especially in the 
new method of ophthalmoscopy. Here, too, he worked 
in the laboratory under Edmund Parkes. Sir Thomas 
Longmore bore enthusiastic testimony, not only to 
Frank's knowledge but to his inspiration as a teacher, his 
excellence as a scientific surgeon and pathologist, and to 
the charm and attractiveness of his personal example 
with the young men who were brought within his 
influence. 

There was no doubt a great future befoie him, but 
his own dysentery experience and his somewhat delicate 
frame made him afraid of being inefficient in the rough 
and tumble of military life, and his innate modesty (a 
life-long quality) made him shrink from an appointment 
in the Director-General's office in London for which he 
was already designated. And so, to the grief of his 
chiefs, in the autumn of 1862 Frank resigned his military 
pdsition. Personal attachment and friendship always 
Hlled a larger place in Frank's horizon than ambition, 
and for. nearly five years at the earnest request of the 
second Earl Brownlow, he became his resident physician ; 
this was no sinecure, for during three of the winters 
which he spent with his patient at Madeira, Frank did 
some consulting work, performed all the post-mortems 
at the hospital, gave demonstrations in pathology and 
taught operative surgery to the students, and actually 
established a clinic of eye diseases. During the summer 



14 



he worked at Brompton and Moorfields and at the 
Samaritan Hospital under his old friend Spencer Wells. 

As quarantine difficulties with respect to Madeira had 
arisen, the next two winters they went to Mentone. After 
Lord Brownlow's death Frank settled at Mentone for a 
time, but in 1868 he transferred his residence to Cannes, 
which, with one important break, was his home until he 
retired from practice in 1898. 

This important break in his life at Cannes was the 
period of his invaluable medical service in the Franco- 
Prussian War. In August, 1870, he joined the National 
Red Cross Society and proceeded to Paris as chief repre- 
sentative of the National Committee. He was appointed 
chief of the Anglo-American Ambulance, and his 
principal activities centred round Sedan. During the 
siege he was at the head of the ambulance at Balan ; his 
operating room was exposed to fire, as it was on the 
road by which the French endeavoured to escape but 
were forced back to Sedan by the Bavarians. 

An extract from the notes and recollections of Sir 
William MacCormac, who was one of Frank's comrades, 
is worth quoting: "May I be permitted after this retro- 
spect to record the deep impression made upon all of us 
by Dr. Frank's noble behaviour, by his skill bolh as 
doctor and surgeon. By his energy, his courage, and 
above all, his unselfishness, he endeared himself to his 
colleagues no less than to his patients. He it was who 
brought the work of the divisions of Balan, work begun 
under conditions of such great difficulty, to a happy and 
successful close." 

Frank returned in the spring to his practice in 
Cannes. During his long residence there of thirty years 
he became the virtual doyen of the English practitioners 
on the Riviera. He was the friend and trusted adviser 
of all his colleagues. His clientele ranged from royal 
personages, great statesmen, distinguished men and 
women of all ranks of life to the poor people of the town 
and district, for he established an eye clinic of his own 



15 



at which the attendances amounted to two thousand in 
the season. 

His thorough ti aining, his wide experience of hfe and 
above all his intense humanity, made him the very bcaiL 
ideal of the beloved physician ; and it is little wonder 
that all sorts and conditions of men and women relied 
implicitly upon his advice. 

When at length a sense of failing vigour led him to 
withdraw from practice, he chose London as his home. 
Then came fifteen years of what might be called his 
resting time. But in spite of his age and on-coming 
infirmities, which he kept at arm's length by his frugal 
and abstemious life, Frank was indefatigable in his 
attendances at the London hospitals. It was, indeed, 
this attraction which was the dominant consideration 
leading to his choosing London for his final home. But 
he always maintained that there was no city like London 
for healthiness during all the year round. 

He regularly visited several clinics, medical and surgical, 
of the London school hospitals. 

He kept himself thoroughly abreast with medical and 
surgical literature both at home and abroad, and I think 
he contributed more than he acquired in our hospital 
clinics by his discriminating recognition of any additions 
to knowledge or method, and by his invaluable hints 
drawn from a very varied experience and given with 
a rare modesty and tact. He was a favourite with 
students wherever he went. They made way for him, 
placed a chair for him within the inner circle of eager 
listeners round the beds, and on his part I can bear 
witness that he took a fatherly interest in them, especially 
those who were worthy but timid. In his quiet way he 
used to encourage them and sometimes asked them to 
come and have tea with him alone when he talked with 
them about their future plans. He was invaluable to us in 
interpreting to poor foreigners and in helping to persuade 
obstinate patients for whom operations were suggested. 
He made friends with the ward sisters, and gave help 



i6 



by stealth to many a poor patient who was leaving 
the hospital and was in sore need. And how delightful 
was his personal conversation when one walked away 
with him after the hospital visit was over. He was over 
sensitive, retiring, unassuming, but when at his ease he 
poured forth treasures new and old ; reminiscences of 
great doctors, of men of affairs and of statesmen, like 
Gladstone and Lord Acton, and of honourable women 
like Lady Marian Alford, and he was always proud of his 
early links with Lancashire and liked to talk of the fine 
integrity of the Manchester merchant which was always 
exemplified to him by the memory of his father. He was 
never ashamed of his jewish blood, he encouraged his 
daughter to make translations from the Yiddish about 
the sufferings and the aspirations of the poor Russian 
Jewish peasants. The works of Goethe and Schiller were 
household words to him and with many of the French 
authors he was equally conversant, especially with the 
great French essayists. He read and re-read, along with 
his daughter, his books of philosophy, but his great 
rejoicing, to the end of his days, was in the advance of 
all physical knowledge and in the conquest of Nature for 
the good of mankind. Meanwhile, although he rigidly 
avoided any new responsibility, he was always ready to 
give of his best to his old patients. When anything 
arose concerning their welfare all his wide and generous 
thoughtful ness was unfolded like an open book and lie 
was timid and retiring no longer. He recognized good 
qualities in people when others were repelled by angulari- 
ties of manner and of speech. I never heard him say an 
uncharitable word of anybody, and when disparaging 
criticisms were made about mutual acquaintances, if he 
did not contradict, he became silent. That expression 
of charitable spirit which seems fitting to a thoughtful 
medical man, which is embodied in Kenan's dictum " To 
know all is to forgive all," was especially characteristic 
of Frank. 

With respect to his relation to this College, Frank took 



17 



the membership in 1859, was elected a fellow in 1871 
and served on the Council from 1900 to 1902. 

There remains to be said a very few words about his 
home life. He was married in 1871 to Lady Agnes, the 
daughter of the second Marquis of Westminster and the 
widow of Sir A. Islay Campbell. Their union was one 
of unfailing devotion on the one side and chivalrous 
attachment on the other. They had one daughter who 
entered into their intellectual and beneficent pursuits 
with the greatest keenness and enlightenment. Lady 
Agnes, though she lived to old age, was very frail and 
needed constant care ; when she died Frank said to me 
" I have wished all these years to keep myself abreast 
with medicine in order that I might be esteemed worthy 
to minister to her needs." Could anything be more 
beautiful as an expression of the highest devotion ? After 
Lady Agnes's death it seemed to me that if anything 
Frank was more solicitous than ever to do good in a 
quiet way to poor hospital folk, and Miss Frank's good 
work in this and other ways was to him the greatest 
solace. 

The end came very quietly ; after a fall on his door- 
step and an apparently slight injury to the face he had 
a mild cerebral seizure and in a few days passed peacefully 
away. 

P'rank's life was a very interesting one, it was full of 
activity from fust to last ; he will be remembered as 
a personality and not by any published works, especially 
for his high standard of general culture, his wide know- 
ledge of medicine, and his keen sense of obligation to 
help those who had been placed under his care. And 
I think that of him it may well be said " Blessed are the 
peacemakers, for they shall inherit the Kingdom of 
Heaven." 



i8 



ALFRED LEWIS GALABIN. 

Alfred Lewis Galabin died on March 25, 1913, 
a^ed 70. He was born at Camberwell in 1843, and was 
descended from an old Huguenot family on the father's 
side, whilst on the mother's side he was of Quaker extrac- 
tion. It may not be entirely fanciful to associate his 
reserved and dignified bearing and his careful, measured 
speech with this fine double ancestry. 

Galabin owed his early education first to a private 
school in Camberwell and then to Marlborough. From 
Marlborough he obtained a minor scholarship at Trinity 
College, Cambridge, and he obtained a double first in 
1866, and was made a fellow of his college in 1868. 

He began his medical studies at Cambridge, and in 
1869 entered Guy's Hospital. He took his M.R.C.S. in 
1872, and his M.B. at Cambridge in the same year. He 
was house physician and obstetric assistant at his own 
hospital, and it was during this period that he devoted 
himself especially to the problems of the circulation and 
amassed the material for his very important thesis for his 
M.D. degree. This was published in 1873, under the 
title of " The Connection of Bright's Disease with the 
Changes in the Vascular System," with illustrations from 
the sphygmograph. He published other papers in the 
Medical-Cliiiiir^ical Transactions, in the Jotirnal of 
Anatomy and PJiysiology,7ind in the G//y's Hospital Reports, 
illustrating the teaching of the sphygmograph in relation 
to circulatory problems, and he invented a simplified 
cardiograph. 

With his appointment as assistant physician to the 
Children's Hospital, Great Ormond Street, and in view 
of his valuable contributions to circulatory problems, it 
seemed that Galabin had laid the foundations for a fine 
career in general medicine, but the death of Dr. J. J. 
Phillips, at Guy's Hospital, gave the opportunity for his 
selection as assistant obstetric physician. 

Henceforth he gradually relinquished the subjects of 



19 



his early investigations and devoted himself heart and 
soul to midwifery and gynaecology. In 1874 he had 
become a member of our College, and in 1878 he was 
elected a fellow. In 1882 he became full obstetric 
physician at Guy's, and thenceforth had a busy period of 
twenty-five years in teaching and practice. He worked 
hard for the Obstetrical Society in all its responsible 
posts, and was examiner in his own department at Oxford, 
London and Cambridge, as well as at the conjoint board. 
His book on Midwifery" was at once recognized as an 
accurate and scholarly work, being specially strong on 
the mechanical side. It passed through no less than 
seven editions, in the last of which he was assisted by 
Dr. George Blacker. It is now a standard English text- 
book. Galabin also wrote a student's hand-book to 
diseases of women, and this, greatly expanded, reached 
a sixth edition in 1903. His work at Guy's Hospital is 
notable because he soon claimed that the performance 
of abdominal operations on the pelvic viscera of women 
was the -proper sphere of work for the gynaecologist and 
his claim was granted. He became a skilful and success- 
ful operator, and his opinion as a consultant was widely 
and deservedly trusted. 

His health was not very good, and in 1903 he retired 
from the staff of the hospital. He maintained his con- 
sulting practice until 1909 when he retired to Bishop's 
Teignton, to a home that had belonged to his grand- 
father. Here it was his great delight to cultivate his love 
of botany and horticulture. He died rather suddenly from 
an attack of acute pneumonia of only five days' duration. 

Galabin was married in 1874 to Miss Baily, who survives 
him ; and he had one daughter. 

By the obstetric branch of our profession Galabin will 
be long remembered as one who brought a many-sided 
culture, especially strong on the mathematical side, an 
interesting personality, and a real attainment in scientific 
medicine to his special department. And besides his 
excellent work in midwifery, he must be remembered in 



20 



the history of hospital policy as a pioneer in the alloca- 
tion to the obstetric officer of surgical operations m 
women's diseases. 



JOHN CHARLES THOROWGOOD. 

John Chakles Thorowgood died at Bognor on 
April 25, 1913, aged 80. He was educated at his father's 
school at Totteridge, and then entered on the arts side 
at University College, London, where he distinguished 
himself in classics. After joining the medical side at the 
same college he took an honourable place both in surgery 
and clinical medicine, and took gold medals at his M.B. 
examinations at the University of London. In 1857 he 
took his M.D. and after some experience in general 
practice as assistant to a relative and a rather lengthened 
charge of a patient in the south of France, he started 
practice in London as a consultant. 

He was appointed physician to the Royal General 
Dispensary in Bartholomew Close, and subsequently 
assistant physician to the City of London Hospital for 
Diseases of the Chest ; it was at this hospital and at the 
West London Hospital, to which he was also attached, 
that most of Thorowgood's life-woik was done. 

In 1872 he was appointed lecturer on materia medica 
and therapeutics of the medical school of the Middlesex 
Hospital, and I am told that he was an effective and 
interesting teacher. 

Thorowgood also did good work as an examiner for 
some years at the Society of Apothecaries, and he was 
consulting phvsician to the Royal National Hospital for 
Consumption.^ He became a fellow of our College in 
1874 and served on our council. 

He gave long and zealous service to the Medical Society 
of London, of which he was one of the secretaries for 
several years, and to which he delivered the Lettsomian 
lectures on bronchial asthma ; these lectures were pub- 
lished and went through two editions, and they form an 



21 



excellent brief resume of the subject ; he also published 
H student's book on Materia Medica, and in his short 
work on the climatic treatment of consumption, the first 
edition of which appeared so far back as 1864, and the 
third in j868, he showed both independence and fore- 
sight. He may indeed be justly regarded as one of the 
pioneers of cold bracing stations, high altitudes, carefully 
graduated exercise, and paramount attention to the diges- 
tion in the treatment of this disease. 

He was married in 1863 ; his wife and four daughters 
survive him. Twelve years ago he retired from practice 
and settled at Bognor. He will be remembered as a good 
physician and a friendly, genial, and honourable fellow 
of this College. 

FRANK BUSZAKD. 

Frank Buszard died on September 14 at Dallington, 
Northampton, aged 74. He was born at Lutterworth, in 
Leicestershire, being the son of a medical man ; was 
educated at Guy's Hospital and took his M.R.C.S. in 
i860. In 1861 he took his M.B. of London, and his 
M.D. in 1865. He obtained the fellowship of the Royal 
College of Surgeons in 1864 and in 1877 became a 
member of our College and was elected a fellow in 1887. 

Buszard's earliest attachment was to the surgical side 
of our profession, for after holding the post of house 
surgeon at Guy's hospital he became house surgeon to the 
general hospital at Northampton. In due time he was 
elected to the surgical staff, but subsequently transferred 
himself to the medical side. He was connected with the 
hospital for fifty years, and lived to see great improvements, 
largely brought about by his own intelligence and zeal. 

Dr. Buszard held a leading position as consultant in 
Northampton and the surrounding district for many 
years, and he held an honoured place in civic affairs and 
on the magistrate's bench. He left a widow, one son 
and two daughters. 



22 



ROBERT LEAMON BOWLES. 

Robert Leamon Bowles died on November 15, 1913, 
a^'ed 79. He was born in Gloucestersliire, and his father 
was a veterinary surgeon and an experienced andtliought- 
fiil practitioner. Bowles was devoted to his memory, and 
has told me how much he owed to his example and 
teaching. 

He was a student of St. George's Hospital and took 
his M.R.C.S. and L.S.A. in 1856, and became a licentiate 
of this College in 1864. He settled at Folkestone where 
he gradually attained the premier position. He was 
physician to the hospital and likewise to the St. Andrew's 
Home. He became a member of our College in 1875, 
took the M.D. degree of the University of St. Andrew's in 
1882, and was elected a fellow of this College in the same 
year. 

Bowles had the great merit of having simplified the 
interpretation of stertor, and of having pointed out the 
practical value of change of posture in the stertor of 
apoplexy. His article on the subject in Quain's Dic- 
tionary is excellent. He gave very considerable attention 
also to the methods of artificial respiration in the treat- 
ment of the apparently drowned. 

He was an enthusiastic Alpine tourist, and wrote an 
interesting paper on sunburn, in which he maintained 
that, so far as the Swiss cases were concerned, it was 
caused by the reflexion from the snow. 

In later years Bowles relinquished his Folkestone 
practice and removed to London, where he had many 
friends and old clients. He practised for some years in 
Upper Brook Street, and in 1905 retired to a small 
property at Prior's Mesne, near Lydney, in his native 
county, where he was devoted to his garden. 

Bowles was married early and had a very happy home 
life. He had three daughters and one son who, with his 
wife, survive him. Bowles had a bright and genial 



23 



personality, he was keen, alert, and enthusiastic in his 
work, devoted to the practical problems of medicine and 
a successful therapeutist. He remained young to the 
very end. 

GEORGE ERNEST HERMAN. 

George Ernest Herman, aged 65, died at his country 
home in Gloucestershire on March ; i, 1914. He was 
born at Kilwarlin in Ireland, was educated at a private 
school, and then entered on the study of medicine at the 
London Hospital. 

He held the posts of resident accoucheur, medical 
registrar, and junior resident medical ofHcer and was 
appointed assistant obstetric physician to the hospital in 
1876. 

Like so many of his contemporaries he had been 
greatly influenced by the bracing teaching of Dr. Sutton, 
and as he had obtained the fellowship of the Royal 
College of Surgeons, as well as the M.B. of the Univer- 
sity of London he had taken pains to make the 
foundations of his specialty broad and sound. 

I knew Herman well in the early part of his hospital 
career for I was a colleague of his for two years, and he 
impressed me as a very accurate observer and as being 
pre-eminently careful in the sifting of evidence. He was 
very much influenced by Dr. Matthews Duncan and I am 
informed that some of his papers in the 'eighties on 
uterine displacements were models in the way of careful 
laborious reports and searching criticism. These papers 
were important because at that time mechanical doctrines 
in his department were on their trial. One of his 
confreres has told me that Herman deserves to be 
described as one of the pioneers of common-sense 
gynaecology. His student's book on midwifery and his 
later works on difficult labour and on the diseases of 
women are, I am told, exceedingly practical and con- 
vincing; they passed through several editions and are 



24 



characterized by the clear terse style which was marked 
in everything he spoke and wrote. 

Herman was a man of few words and reserved 
character; he never courted popularity and was singularly 
candid and careful in all his utterances ; he was an 
able teacher and a successful operator, very averse to 
undue surgical interference. It is characteristic of him 
that he was admired and beloved most of all by his 
resident assistants who knew him best. He was held in 
high regard at the obstetrical society, of which he was 
a very active fellow and ultimately president. Besides 
his post at the London Hospital he was for a considerable 
time physician to the Royal Maternity Charity and to the 
Lying-in Hospital at Lambeth. 

He was elected a fellow of our College in 1885, and he 
served on our Council and examined in midwifery at our 
Conjoint Board and at several Universities. 

Herman was married in 1884 to Miss Emily Gibbings, 
of Chichester ; he leaves one daughter and four sons, one 
of whom is a medical man. 

About twelve months ago he retired to his country 
home at Cam in Gloucestershire, where he had a happy 
and peaceful time, ended all too soon by a sudden attack 
of acute bronchitis with heart failure. 

In him this College has lost a good physician, and 
a man of strong, sterling character who had done able 
and faithful service for his generation. 



25 



APPENDIX. 

I.— REPORT FROM THE CENSORS' BOARD 
CONCERNING THE EMPLOYMENT OF 
NON-QUALIFIED PERSONS UNDER THE 
INSURANCE ACT. 

In the course of last year communications passed between 
the Censors' Board and the Insurance Commissioners on the 
subject of the employment of non-quaUfied persons under 
the Insurance Act. Tlie contention of the Commissioners 
appeared to be that, while none but registered medical 
practitioners are admissible to the panels, yet there was 
nothing in the Act of igii to prevent insured persons who 
are allowed or required to make their own arrangements for 
medical benefit, from making such arrangements with persons 
who are not legally qualified medical practitioners. 

More recently the Commissioners " for the purpose of 
removing doubts and for the convenience of Insurance Com- 
mittees" have altered the Regulations in this respect, and in 
their new Regulations [National Health Insurance (Medical 
Benefit) Regulations, 1913, Section 44 (2)] , and in a " Memor- 
andum with regard to persons making their own arrangements 
under Section 15 (3) of the National Insurance Act, 191 1," 
the possibility of treatment by unqualified persons under this 
Section of the Act is specifically recognized, and provisions are 
made with respect to it. 

The president and censors consider that to give to un- 
qualified persons any status whatever under an Act of 
Parliament is an innovation which should not pass unnoticed 
by the College. 

They therefore submit the following resolution for the 
consideration of the College : — 

National Health Insurance Medical Benefit 
Regulations, 1913. 

The College observes with regret that in Section 44 (2) of 
the National Health I nsurance (Medical Benefit) Regulations, 



26 



iQiS.and in the memorandum issued in connection therewith, 
provision is made whereby insured persons who make their 
own arrangements for medical benefit under Section 15 f 3) 
of the National Insurance Act may obtain treatment from 
non-qualified persons. 

Hitherto none but duly qualified medical practitioners have 
been employed, as such, in any public capacity, and the 
College deplores that now, for the first time, under an Act 
professing to promote the health of the nation, recognition 
should be given and public money paid to a class of persons 
who have not obtained a legal qualification to practise medicine 
and concerning whose medical knowledge there exists no sort 
of guarantee. 

This report was accepted and approved by the College. 

II._STATEMENT ISSUED BY THE ROYAL 
COLLEGE OF PHYSICIANS OF LONDON 
ON THE INFECTIVITY OF TUBERCULOSIS. 

(1) Tuberculosis is an acquired disease, but certain consti- 
tutional types may be inherited which render the patient 
specially susceptible to infection, and there is reason to think 
that such susceptibility is an inherited character. 

(2) The infective agent is the tubercle bacillus. This may 
be contained in the various discharges and excreta of the 
patient, and especially in the sputum of those suffering from 
pulmonary tuberculosis. No discharge is infective as regards 
tubercle unless it contains the tubercle bacillus. 

(3) Cases of tuberculosis of bones, glands, and internal 
organs from which there is no discharge or which do not 
furnish any excretion, and cases of arrested pulmonary 
tuberculosis, have never been proved to be infectious. 

(By arrest is here meant that all the symptoms and physical 
signs of activity have disappeared, and the sputum has either 
ceased or no longer contains tubercle baciUi.) 

(4) The means by which tubercle bacilli may enter the 
body are : — 

(a) By Inoculation through a wound or abrasion of the skin. 
This has occasionally occurred to workers in laboratories, 
post-mortem attendants and others dealing with tuberculous 



27 



material, and is presumably the way in which lupus is 
acquired. 

(b) By Inhalation. — Susceptible animals are readily infected 
by the inhalation of air containing tubercle bacilli, whether in 
droplets or suspended as fine dust, but in the spread of the 
disease among human beings the latter appears to be the 
more important means of infection. The sputum or other 
discharges, whether on soiled handkerchiefs, linen, garments, 
or elsewhere, when dried, may become pulverized, and in this 
condition may be readily dispersed in the air of a room. 
That droplets of sputum are less important agents of infection 
is suggested by the fact that the incidence of consumption 
upon the staff, nurses, and others engaged in hospitals for the 
treatment of tuberculous disease, where all discharges are 
carefully disposed of, is not above the average in the general 
population. 

(r) By Simllowing. — Dust infected by the tubercle bacillus 
may be conveyed to food and so enter the alimentary canal ; 
or infection may occur more directly in the act of kissing, or 
by consumptive and healthy persons using the same food 
utensils. As about lo per cent, of the milk supplied to large 
cities contains tubercle bacilli derived from infected cows, this 
avenue of infection is particularly important in the case of 
children. The bovine tubercle bacillus is more commonly 
responsible for tuberculosis in young children than in adults, 
but the proportion of cases due to it varies very much in 
different localities. 

There is no evidence that tuberculosis can be conveyed to 
others either by the breath alone, or by emanations from 
patients, or by their garments, unless soiled by dry sputum 
or discharges. 

(5) The spread of tuberculosis is favoured by uncleanliness, 
overcrowding, and imperfect ventilation, and is hindered by 
the opposite conditions. Experience in hospitals and other 
institutions where the following precautionary measures have 
been thoroughly carried out indicates that by such measures 
the risk of infection is reduced to a minimum, namely— 

{a) The careful disposal and disinfection of the sputum and 
other discharges. 

{b) The disinfection or destruction of soiled handkerchiefs, 
clothes and linen. 



28 



{c) The removal of dust by frequent moist cleansing of the 
floors, walls, &c., of the rooms. 

{d) The supply of abundant air space, and free ventilation, 

with fresh air. 

No risk is incurred by living in the immediate neighbour- 
hood of institutions for the treatment of tuberculosis which 
are properly conducted. 

April 6, 1914. 



John Bai.e, Sons & DANinLSSON, Ltd., 83-91, Great Titchfidd Street, W. 



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